Florence Birth Story: Kim and Ariel at the Centro Margherita

Kim is from Australia and has lived in Florence for six years. She first came here to visit a friend and met a yoga teacher with whom she wanted to continue studying. So she came back a year later, student visa in hand. It was during this second, longer stay that Kim met the future father of her child, and she’s been here (on and off) ever since.

When you got pregnant, did you take any prenatal classes?

Yeah, I did the one offered at Careggi, which I think is run by the Centro Margherita. And it was really good because it was a close-knit group of girls who stayed in contact even after the birth. So that was a really positive side of it. But it wasn’t really the kind of course I was looking for because it was mostly talking, which was nice, but I could have gotten that information from a book probably. It was good to meet other Italian mothers and have that bond, but I wanted a course I could do with my partner that would prepare us both.

Like with breathing…?

Yeah, and also just to begin spending some time [preparing together], because I was doing yoga every day, so it was easier for me to get ready for that moment—as much as you can. But I would have liked him to be more prepared. I think when we got to the actual birthing centre he was great but when we were [at home], without anyone else taking the lead, it was a bit more daunting for both of us. But once we got there and we had two midwives guiding the whole process, he really stepped up and I think felt more relaxed too. I was hoping that a course together might have given us both that confidence to feel ok at home as well.

Can you say for certain that all the yoga you did in preparation helped with the birth?

I think it did. Though I thought it would help more! But I don’t know if that’s an unrealistic expectation because in the end, I don’t know if there’s anything anyone or any course could have done to help with what made our birth long and difficult. He had a really short umbilical cord and he was just stuck. And because he couldn’t turn around he came out posterior [occiput posterior position].

I think the yoga helped the most with the first part of the labour, and relaxing into the dilation, and just letting that happen. Letting go and releasing, and trusting that your body knows how to do that, your body is made for the possibility of birthing a baby.

What made you choose to go to the Margherita?

I really, really wanted to have a natural birth. And I really liked the idea that Emilio could stay afterwards. And I wanted to try and have a water birth. Apart from Borgo San Lorenzo, I think it’s one of the only places where you can be sure. Because I know Ponte a Niccheri has a tub, but if that one’s taken…I didn’t think I was going to get into the Margherita because there’s the “checkpoint” [a strict evaluation to determine eligibility for admittance] and I was sure I wasn’t going to pass it. So I was starting to consider Borgo San Lorenzo. But I was thinking that’s so far and what if things happen fast, isn’t it better to be close… It just seemed like such a nice centre, and I really wanted to not have it medicalized as much as possible.

How was the experience overall?

Overall, good. Obviously things didn’t go perfectly but what birth does? It was hard and long, but in a way I wouldn’t change anything, because in the end we didn’t have to get any major medical intervention. I think the great thing about the midwives that I did have was they did really fight for my choices. I felt like they were really invested in the same outcome that I was. Even when it got to the point that things were going really long, I felt like they really wanted to see this baby be born as well. Obviously they have a lot of rules, as everyone knows. There are no gynecologists or obstetricians present so they need these rules for safety. If you need a doctor then you have to be transferred to Careggi. And they even said, Look, for our rules it’s going a bit long. But the one reason they said they could keep us was that Ariel never showed any signs of distress, throughout the whole process. They said, As soon as that happens, we’re going to have to send you across. But if his heartbeat stays strong you can stay here if that’s what you want. And that’s what I wanted.

So how long was it?

The first contraction started at six a.m. the day before my due date, but for the first six hours I was able to go ahead normally and walk the dog, have breakfast and then lunch etc. Then at about one p.m. things started to get serious, and the contractions were five minutes apart. At around two p.m. we went to the Margherita, but like a lot of first time mums by the time we got there things slowed down again, and they sent us home. As soon as we got back in the car the contractions were closer together again, but we went home anyway, and by six p.m. we were back in the car and this time they admitted me as things kept progressing. He was born at two-fifty in the morning.

Oh, that’s not so long.

Yeah, but the pushing went on for a long time. I was fully dilated by about a quarter to twelve. I remember looking at the clock, strangely enough, I don’t know why. We were in the tub and they said, Ok, everything’s going well, you’re fully dilated, you can start pushing. And they said he was fine and he could be born in water, that there was no problem. So I started pushing at quarter to twelve and he was born at ten to three so…it was the pushing that went on too long. After half an hour pushing in the water they told me to get out. They said, It’s not that anything’s wrong but maybe you need the help of gravity, maybe the water’s just not helping you in this case. In terms of safety everything was fine for the water but they said, Maybethings will go a bit quicker if you get on land at this point. And so we got on land and we tried every position [laughing]. Half an hour of this, half an hour of that—everything known to them and that I’ve ever read about, one after the other, and we just weren’t getting anywhere. So it started to get pretty hard. And my water still hadn’t broken so they said, We’re really sorry but we’re going to have to break your waters because maybe they’re getting in the way of him coming out. So they broke the waters in the end, to get him out.

You started pushing before your water broke?

Yeah, but they said this can happen…

[We get interrupted by our kids.]

[Several minutes later] So we were talking about the birth, and we were getting towards the end…

Yeah, so it was going long, but luckily he didn’t show any distress. They told me at the first sign of baby distress, we can’t keep trying this natural birth. But I think they did sort of whisper to Emilio that if I went over to Careggi that they would intervene pretty heavily, because I was starting to lose energy and the contractions were getting weaker. He was pretty stuck. So after we tried every single position that they could think of they said alright, we can try one last thing or we can go to Careggi. They said we could try this really old-fashioned gynecological position where you lay down on your back, which is really the worst position, as we all know, and they could try to push him out by pushing down on my belly. They said it was this or Careggi. At this point they could even see his head and they were saying, Come on, one last push, we can even see that he’s got black hair! So I couldn’t even imagine being transferred when he was right there. And part of me also knew that once we were there we would be intervened with medically pretty heavily…so I said, Yeah, I want to try it. So they laid me down on the gynecological bed and two midwives pushed and one was there waiting. A few pushes like that—and it was terrible—and he was half out and then they said, Ok, after this push we’re going to have to send you if he doesn’t come out, or we’re going to have to cut. And I was like, Ok! I just wanted him to come out. And I think the last thing I said to Emilio was, We’re not going to Careggi! I was going to give it this one last shot. At this point, we’d come so far, and he was still ok. So they cut and he came out in one go. I actually thought it was only the head and that we still had to do the shoulders. So I was getting ready for another push when they put him on my belly! And I have to say that one moment when they plopped him on top of me, that was worth all the craziness before.

Did you face any challenges at any point as a foreigner?

No, I honestly don’t think so. And that’s what I was really scared of, because I thought I would. The two midwives I had there were amazing. I did know someone I talked to afterward who had trained there as well as in other hospitals. And she told me that it’s a great place, but that in her mind Ponte a Niccheri was a better option. The risk at the Margherita is that, because there are so many rules, if there’s any baby distress [for example], the mother has to change environments halfway through the birth. And you’ve got to think about what that would be like for you. That’s the risk you run, that you’ll be transferred over to Careggi. Whereas at Ponte a Niccheri, you might not be guaranteed that the tub will be free to have a water birth, but you know you’re staying in the same environment. Anyway, she knew the two ostetriche that had been had my birth and she said, I think you’re really lucky you didn’t get transferred and that’s probably because of them, they’re two of the best and the nicest and they probably fought really hard for you. It’s hard because Ponte a Niccheri is great for promoting breastfeeding and natural birth…but I had this really strong feeling all along that I wanted to go to the Margherita, I don’t know why. I had this strong feeling that he would be born there, and somehow we managed to pull it off. But when they started saying, We’re going to have to send you over there, I was like, Oh god! Because Emilio had said to me, Think about that, because it can happen; you really have to think about it. We were so lucky.

Would you try to do it there again?

I don’t know! I think I would. I don’t know though…

What do you wish you’d known beforehand?

I suppose one thing is that I read a lot of the natural childbirth literature, and one thing that shocked me—though I guess it was the type of birth, because he was stuck—but [the literature] really uses different words, it’s all about opening… And it got to a certain point when what [the midwives] said got quite strong and it was the opposite of what I thought. They were saying I had to get really angry: You’re not pushing hard enough, stop being so soft and gentle about it. Get really incazzata! And I was like, Ok! But it was kind of against everything I had preconceived in my mind, and maybe that’s why I struggled. It ended up being quite strong. It was hilarious because they would say, You can do better! And I was like, I don’t think I can! Yeah, they got quite nasty, in a good way. They really pushed me. And I didn’t ever imagine it could go like that. I thought it was going to be all soft and gentle. They told me that I had to get angry and I was like, Wow. I never prepared myself for that kind of scenario.

I suppose the main thing I would do differently next time is try to claim more space to go with my own instincts more…But I started to feel the momentum of the threat to be moved to Careggi and I started going too much with their directions to push, rather than seeing that as a cue to dig deep inside myself and find the connection in my own body to push. So I suppose, as great as I thought my midwives were and the Margherita in general is, it’s the whole “threat” of being moved that also makes it a possible negative to the birth. You do take that pressure in there with you, and you can get lost in the heat of the moment. It was probably time for me to get serious about pushing, but that impetus had to come from me rather than from outside of me. I still can’t figure out whether I had such a hard time pushing him out because of his posterior position or because I wasn’t pushing in the right way. The midwife did say when he was born, Ecco perché, referring to his really short cord.

I also question if it was possible to know that Ariel had a short umbilical cord before the birth so we could prepare for that. I have since read up a bit on posterior position births and there seems to be some advice for exercises etc. on how to help the baby turn before the birth, but maybe his cord was too short to allow this. Who knows. But we do so many ultrasounds throughout the pregnancy, so I wonder if that is detectable. Anyway, maybe it’s better we didn’t know all this as it’s possible I would never have been “allowed” by the medical professionals to birth him naturally! And in the end he came through the labour healthy and with no signs of distress, and scored a ten on the APGAR test they do, so obviously babies can come out it in all positions, not just the most common one, and do just fine.

What about after the birth, did you consult with anyone?

Yeah, I had to go back to them, because I had stitches. And I had problems actually—they didn’t heal well. That’s a whole other story. It was a bit tough. That’s one reason I don’t know if I’d be able to go back to the Margherita. I almost had to have the stitching re-done and they wanted to put me in Careggi two weeks after the birth and put me under anesthetic, but I had fought so hard to have him naturally… So I chose the long painful option in which it just heals itself.Did you get or need any support for breastfeeding?Yeah, actually it hurt a lot in the beginning. And I got some advice from the midwives who were there at the birth when I ran into them when we went back. But I would have liked more. I know in Australia you have a maternal nurse assigned to you till the child is five years old. They come out to your house to check on you. So if you have questions about anything…Because we struggled in the beginning. For the first month, it was painful but I kept up with it and eventually it just stopped being painful. I wondered if his latch was right, and things like that. So a little more support would have been good. And maybe I would have had less issues with the stitches if there was someone coming out instead of having to go there myself in the August heat… I never knew there was anything really wrong with the stitches until it was too late. I just thought it was normal to be sore.